Supreme Court Rules Hobby Lobby Not Required to Pay for Birth Control

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The Supreme Court has ruled that certain "closely held" for-profit businesses can cite religious objections in order to opt out of a requirement in the Affordable Care Act (ACA) to provide free contraceptive coverage for their employees.

In a 5-to-4 decision, the Supreme Court has ruled
that requiring family-owned corporations to pay for insurance coverage
for contraception under the Affordable Care Act (ACA) violates a federal
law protecting religious freedom.

As part of the ACA, the federal
government issued a rule that requires health plans to cover
contraception without a co-pay. Under the final rule, the administration
has allowed exceptions for nonprofits with religious objections to
covering contraceptives. The rule was designed to ensure that employees
could receive contraception coverage, but that a nonprofit employer with
religious objections would not bear the cost or otherwise have any
connection to it.

However, on November 26, 2013, the Supreme Court
announced it would hear two challenges to the contraception rule: one
from an Oklahoma-based craft supply chain store (Sebelius v. Hobby Lobby
Stores, Inc., 13-354), and another from a Pennsylvania-based furniture
manufacturer (Conestoga Wood Specialties Corp. v. Sebelius, 13-356).

Ginsburg Says Coverage Is Vital to Women’s Health

Justice
Samuel A. Alito Jr., wrote for the majority that a federal religious freedom law applied
to for-profit corporations controlled by religious families, and that
the requirement that the companies provide contraception coverage
imposed a substantial burden on the companies’ religious liberty,
according to a report in the New York Times.

Justice Ruth
Bader Ginsburg said in a written dissent that the contraception coverage requirement was vital to
women’s health and reproductive freedom. Justices Stephen G. Breyer and
Elena Kagan joined Justicce Ginsburg in almost all of the dissent, but they said there was
no need to take a position on whether corporations may bring claims
under the religious liberty law, said the New York Times report.

Women's Groups React Strongly

In
March, Healthline reported from a joint press conference that
the American Civil Liberties Union (ACLU), the National Women’s Law
Center, the Planned Parenthood Action Fund (PPAF), and NARAL Pro-Choice
America were opposed to for-profit companies challenging the
ACA's requirement that employers cover contraception
costs for employees because of the religious objections of their owners.

Commenting
on the Supreme Court’s decision, Cecile Richards, president of PPAF,
said in a press statement, “Today, the Supreme Court ruled against
American women and families, giving bosses the right to discriminate
against women and deny their employees access to birth control coverage.
This is a deeply disappointing and troubling ruling that will prevent
some women, especially those working hourly-wage jobs and struggling to
make ends meet, from getting birth control.”

Emphasizing that the
ruling does not strike down the Affordable Care Act’s birth control
benefit, Richards added, “Today, more than 30 million women are eligible
for birth control with no co-pay thanks to this benefit, and the vast
majority of them will not be affected by this ruling. But for those who
are affected, this ruling will have real consequences.”

Richards said that despite this and other political conflicts on the subject of reproductive health, birth control is not a controversial issue for the majority of women.

“Birth
control is basic healthcare – and it’s only a ‘social issue’ if you’ve
never had to pay for it. We hope most businesses will do the right thing
and let women make their own healthcare decisions. We urge Congress to
act and protect women’s access to birth control, regardless of the
personal views of their employers,” urged Richards.

According to
Planned Parenthood, 99 percent of American women between the
ages of 15 and 44 who are sexually active have used birth control at
some time. Other methods of contraception, such as IUDs, can cost several hundred
dollars, even with health insurance. For the first time, under the birth
control benefit, IUDs are now fully covered by insurance companies,
without additional out-of-pocket expense.

Will the Decision Create Barriers to Healthcare?

Dr.
David A. Fleming, FACP, president of the American College of Physicians
(ACP), issued a statement that said the ACP is deeply concerned about
the adverse impact on healthcare that may result from today’s Supreme
Court ruling. "We believe this
decision will make it more difficult for women to access affordable
contraceptives, and potentially open the door for for-profit employers
to seek additional exemptions from other evidence-based coverage
requirements established by the ACA," he said.

Fleming said that according
to the U.S. Department of Health and Human Services, 71 million
Americans received expanded evidence-based preventive coverage
with no out-of-pocket costs in 2011 and 2012 as a result of the ACA. "Since
implementation of the women’s preventive health benefit, women have
saved millions of dollars in out-of-pocket costs for contraception and
may now access a wider variety of high-quality care options," he said.

Fleming
went on to say that the ACP is concerned that allowing employers to carve
out exemptions to the ACA’s requirement that health insurance plans
cover evidence-based preventive services will create substantial
barriers to patients receiving medical care. The Supreme Court has stated that their decision applies only to the contraception mandate, and not to other potential religious exceptions for
vaccinations or blood transfusions, for example.

Fleming
concluded, "We urge the administration,
Congress, and other policymakers to work together to develop a remedy
that ensures that women are not denied access to no-cost contraception
as a result of the Supreme Court’s ruling, and more broadly, to ensure
that all Americans will have access to coverage for evidence-based
medical care as recommended by their physicians."